Archive for the ‘Infant & Pregnancy Safety’ Category

Sudden Infant Death Syndrome; Vital Information Every New Parent Should Know

Tuesday, November 3rd, 2009

Crib_and_parentswebSudden infant death syndrome, commonly known as SIDS, refers to the sudden unexplained death of an apparently healthy infant under the age of one. It is the most common cause of death in infants between the ages of one month and one year in developed countries. The risk in the United States is .57 per 1000 births. Families that have lost one child from SIDS have a higher risk of recurrence.

Interesting facts about SIDS:

  1. More common in boys than girls (60:40 ratio)
  2. Peaks between 2 to 4 months and generally occurs before 6 months of age
  3. Blacks, American Indians, and Native Alaskans have 2 to 7 times the risk over the national average
  4. Japan and Netherlands have the lowest incidence; New Zealand has the highest; USA and UK are intermediate risk
  5. Risk is declining worldwide
  6. Premature infants with low birth weights have four times the risk of SIDS compared to full term infants.

Risk factors for SIDS

  1. Sleep position
    Numerous studies have shown that the supine position reduces the risk of SIDS by a factor of 20. Both side position and prone position have similar risks and should be avoided.
  2. Maternal smoking
    Prenatal and postnatal smoking both increase the risk of SIDS. Findings show that smoking decreases lung volume and heart rates in the infant. Nicotine also causes detrimental effects on the infants ability to respond to low oxygen levels.
  3. Soft bedding and accessories
    Pillows, quilts, comforters, and porous mattresses all increase risk of SIDS. Infants should not sleep on a couch or armchair. The American Academy of Pediatrics recommends that infants sleep on a firm surface without accessories.
  4. Warm room temperatures
    Overheating of infants with multiple blankets, clothing layers, in a warm room increases the risk of SIDS, especially when infants are placed in the prone position.
  5. Bed sharing
    Co-sleeping increases SIDS risk especially for infants under 11 weeks of age, when the mother smokes, drinks, or is overtired and the infant shares the bed for the entire night. Half the infants who die of SIDS in the United States co-share beds. The ideal environment is in a crib or bassinet separate but near the mother’s bed.
  6. Pacifiers
    Risk of SIDS is reduced with use of pacifiers. These infants have been found to have improved ability to breathe with their mouth and have less of a chance of oropharyngeal obstruction.

What Causes SIDS?

The cause of SIDS is due to three important factors occurring coincidentally

  1. Vulnerable infant—the theory is that children that succumb to SIDS have abnormalities in their arousal system and are unable to compensate for low oxygen levels. This ability is controlled by certain parts of the brainstem and hypothalamus. There are probably genetic differences that involve serotonin transport activity in the brain and the autonomic nervous system.
  2. Critical developmental period—the child must be within the first year of life
  3. Exogenous source—an outside stress like prone sleeping or nicotine exposure.

What Are Some Misconceptions About SIDS?

  1. Apnea monitor—There is no evidence that they are useful in preventing SIDS
  2. Immunizations—There is no evidence that immunizations increase the risk of SIDS
  3. Breast feeding—there is no evidence that it protects an infant from SIDS

SIDS is due to an interaction between genetic and environmental factors. Teaching parents safe sleeping practices for their infants is essential in reducing the risk of this disease. In particular, sleeping children on their backs, avoiding tobacco and alcohol use, avoid overheating the infant, sleeping children on a firm mattress in a separate bed without accessories , and use of a pacifier can reduce the risk of this problem.

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New Study Warns Against Prolonged Time in Car Seats for Infants

Monday, August 31st, 2009
Baby in Car Seat.

Baby in Car Seat.

Safe transportation of infants, both preterm and term, with the use of car seats and car beds is essential. Car seats and car beds prevent injury and death according to the National Highway Traffic and Safety Administration. However, previous studies have shown some respiratory compromise occurs in preterm infants placed in car seats. It has now been demonstrated in a study by L. Cerar from Pediatrics August 2009 that the same might be true of full term infants.

Two hundred newborns were evaluated on the second day of life by measuring oxygen levels and breathing patterns in car seats, car beds, and cribs. The same infants measured in each of the devices also served as their own controls. It was found that oxygen levels were significantly lower in both car seats and car beds compared to hospital cribs. In addition, even those infants that were able to compensate for the respiratory limitations initially were found to develop respiratory compromise with prolonged periods of time due to deeper sleep stages and more chest wall muscle fatigue.

The reasoning behind the findings is that there is some obstruction to the airway due to flexion of the head when an infant is placed in the car seat or car bed causing these lower oxygen levels. The other important factor is some compromise of the chest wall motion that occurs in the upright position even though the safety belt was standardized to allow for 1 finger width distance between the infant and the harness.

The conclusion from this important study is that parents should only use car seats and car beds for travel and not as a replacement for a crib. Infants should not be placed in these transport safety devices for prolonged periods of time. Finally, manufacturing companies should brainstorm on how to redesign these devices to eliminate the respiratory compromise that occurs when infants are placed in the upright position with flexion of the head for prolonged periods of time. Most pediatric specialists do not feel that the implications of this compromise is significant in the long run but others feel that even a mild amount of obstruction might be associated with behavioral problems and IQ deficits.

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Should pregnant women use seat belts?

Monday, June 22nd, 2009

Many pregnant women have  concerns about using seat belts  when driving because of fears that  the constraint might be more harmful to the baby during an accident. However, new research has shown that seat belts and airbags reduce the risk of trauma, fetal loss, and early delivery caused by motor vehicle accidents.

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How Does Air Flight Affect Pregnant Women?

Monday, June 15th, 2009

With summer vacations approaching, holiday air travel is common. Pregnant women often question the safety of air travel.

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Swimming Pools and Saunas—Are They Safe in Pregnancy?

Monday, June 8th, 2009

With the summer months approaching, pregnant women are concerned about the risks to themselves and their baby in swimming pools and saunas. There is no question that the risk of bacterial, viral, and parasitic infections can increase during this time.

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Circumcision — The Cutting Edge

Wednesday, May 20th, 2009

The debate over circumcision is centuries old. Worldwide, about 25% of males undergo this procedure. In the United States, over 60% of males are circumcised. New evidence has recently emerged that brings forth additional benefits of this procedure, making it more appealing to new parents.

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The information provided in these articles and on this website is intended for educational and informational purposes only.
This information should not be used in place of an individual consultation or examination or replace the advice of your medical professional,
and should not be relied upon to determine diagnosis or course of treatment.
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